Cystic echinococcosis (CE) is a worldwide parasitic zoonosis caused by infection of the larval stage of tapeworm Echinococcus granulosus. In human CE, the parasites develop and form cysts in internal organs. The differentiated cysts can be classified into five types based on WHO-IWGE standard CE1-5 representing different developmental stages. Infection with E. granulosus triggers hosts’ humoral and cellular response, displaying elevated serum antibodies and Th1 and Th2 cytokines, which are presumed to be in association with the disease outcome. Identification of immunological markers for evaluation of disease progression has been a growing concern. However, the distinctive profile of cytokines and antibodies associated with the cyst progression has not been ascertained. To better understand the interaction between host immune response and disease outcome, the present study followed-up four CE patients over three years by yearly measuring serum level of 27 cytokines, total IgG and isotypes, and ultrasound scanning, beginning in year 1 for all patients with CE1 and CE2 cysts before treatment and continued in year 2 with CE4 and in year 3 with CE3-CE5 post-treatment. Nine cytokines including Th1-type IL-2, Th17-type IL-17A, and inflammatory cytokines IL-1β, IL-1Rα and TNF-α, chemokines IL-8, MIP-1α, MIP-1β, and growth factor G-CSF were significantly elevated in patients with cyst type CE1, compared to the normal controls, and then declined to a normal level at CE4 and CE5. Examining the antibody production, we found that serum specific IgG was significantly increased in patients with active and transitional cysts, specifically the total IgG at CE1/CE3/CE4-CE5, IgG4 at CE1 and IgG1 at CE1/CE3 cyst status, in comparison with the normal controls, but showed no significant changes between the cyst stages. Our findings provide new information on the profile of multiplex cytokines and serum antibodies associated with cyst stages in cystic echinococcosis patients through a three-year follow-up, implying that further studies using an approach combining cyst-associated immune parameters may aid in identifying immunological markers for differentiation of disease progression.

中文翻译：

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囊肿性包虫病患者在三年随访中的多囊性细胞因子和抗体谱，与囊肿分期有关

囊性棘球co虫病（CE）是一种世界范围内的寄生虫人畜共病病，是由tape虫细粒棘球oc虫幼虫期感染引起的。在人类CE中，寄生虫会在内部器官中形成并形成囊肿。根据代表不同发育阶段的WHO-IWGE标准CE1-5，可将分化的囊肿分为五种类型。颗粒大肠杆菌的感染触发宿主的体液和细胞反应，显示出血清抗体以及Th1和Th2细胞因子升高，推测与疾病结果有关。鉴定用于评估疾病进展的免疫学标记物已成为越来越多的关注。然而，尚未确定与囊肿进展相关的细胞因子和抗体的独特特征。为了更好地了解宿主免疫反应与疾病结局之间的相互作用，本研究对三年中的四名CE患者进行了随访，方法是从第一年开始对所有患者进行年度测量27种细胞因子的血清水平，总IgG和同种型以及超声扫描治疗前使用CE1和CE2囊肿，治疗后第二年继续使用CE4，第三年继续使用CE3-CE5。九种细胞因子，包括Th1型IL-2，Th17型IL-17A，炎性细胞因子IL-1β，IL-1Rα和TNF-α，趋化因子IL-8，MIP-1α，MIP-1β和生长因子G-与正常对照组相比，CE1型囊肿患者的CSF明显升高，然后在CE4和CE5处降至正常水平。检查抗体产生后，我们发现活动性和过渡性囊肿患者的血清特异性IgG显着增加，具体来说，与正常对照组相比，CE1 / CE3 / CE4-CE5处的总IgG，CE1处的IgG4和CE1 / CE3处的囊肿状态的IgG1与正常对照组相比，但在各囊肿阶段之间没有显着变化。我们的发现通过三年的随访提供了与囊性包虫病患者的囊肿分期相关的多种细胞因子和血清抗体谱的新信息，这意味着使用结合囊肿相关免疫参数的方法进行的进一步研究可能有助于鉴定免疫标志物区分疾病进展。